PV Bleeding
Non pregnant/ pre menopause
Pregnant
<20/40
>20/40
Post-menopausal
- Dysfunctional uterine bleeding
- Fibroids
- Endometriosis/ Adenomyosis
- PID
- Endometritis/ Cervicitis/ Salpingitis
- Ectopic pregnancy
- UTI
- Bowel cancer/ haemorrhoids
Pregnant
<20/40
- Ectopic pregnancy
- Miscarriage (threatened, inevitable, incomplete, complete, missed)
- Cervical/ vaginal/ uterine lesions (Cervical ectropion - contact bleeding of endocervix/ PID/ vaginitis/ trauma/ warts/ fibroids/ polyps)
- Cervical insufficiency
- Implantation bleeding (small bleed 10-14d post fertilisation = time of missed menses. Dx of exclusion)
- Malignancy (Cervical/ Endometrial)
- UTI
- Bowel cancer/ haemorrhoids
>20/40
- Bloody show (? cervical insufficency if early)
- Placenta Previa
- Placenta abruption
- Vasa previa
- Placenta accreta/ increta/ percreta
- Uterine rupture
- Cervical/ vaginal/ uterine lesions (Cervical ectropion - contact bleeding of endocervix/ PID/ vaginitis/ trauma/ warts/ fibroids/ polyps)
- PID
- Malignancy (Cervical/ Endometrial)
- UTI
- Bowel cancer/ haemorrhoids
Post-menopausal
- Vaginal Atrophy
- Endometrial Polyps
- Endometrial Cancer
- Hormonal Bleeding
- Cervical Cancer
- PID
- Endometritis
- UTI
- Bowel cancer/ haemorrhoids